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THE EXACT DISTRIBUTION of the GASTRIC GLANDS in MAN and in CERTAIN ANIMALS by Y

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THE EXACT DISTRIBUTION of the GASTRIC GLANDS in MAN and in CERTAIN ANIMALS by Y THE EXACT DISTRIBUTION OF THE GASTRIC GLANDS IN MAN AND IN CERTAIN ANIMALS By Y. MIYAGAWA, M.D., Assistant Prof. of the Med. Faculty of the Imperial University, Tokio From the University College Hospital Medical School, London INTRODUCTION THE gastric glands in man and in lower animals are generally classified into three groups, namely: cardiac, fundus and pyloric. The cardiac gland is however not always considered as an independent kind of gastric gland, but as belonging to the fundus group. Some authors describe a few mucous glands, principally in the prepyloric area. The pyloric and fundus glands are the most important forms, from both the pathological and the physiological points of view. The usual statement made with regard to the localization of these forms of gastric glands is that the pyloric glands occupy the pyloric region, the fundus glands the fundus and the body of the stomach, and the cardiac a narrow area surrounding the cardiac orifice. I cannot however find any description which deals with their exact distribution. To know this is of capital importance from both physiological and pathological standpoints; for example, from the point of view of the study of the gastric secretion with regard to hydrochloric acid and the ferments, or from that of the study of the localization or genesis of gastric ulcers and of carcinoma, and* of their relationship to the various types of gastric glands. The observation of Pawlow, Heidenhain, Edkins and Starling mark epochs in the study of the gastric secretion, but in those researches apparently no definite attention has been paid to the exact distribution of the gastric glands. In the present investigation I have mapped out the exact distribution of these three types of gastric glands in the stomachs of two adults and one infant, and also in the guinea-pig, rabbit and cat. METHOD OF INVESTIGATION The stomach used in this observation was opened in luke-warm physio- logical salt solution, its contents removed and the mucous membrane thoroughly washed in that solution. It was then stretched and pinned out on cork, thus obliterating the folds of the mucous membrane, and after fixation in 8 per cent. formalin solution was cut into serial sections and stained with haematoxylin id eosin, iron haematoxylin and Van Gieson, methylen blue and fuchsin. For the systematic microscopical examination, Distribution of Gastric Glands in Man and Certain Animals 57 the posterior wall of the stomach was divided into longitudinal strips, each 1 cm. broad and each strip was then cut into blocks 2 cm. long. The blocks were cut into sections in the longitudinal direction with a microtome by the paraffin method. The anterior wall was divided into squares as in fig. 1, the number varying according to the size of the animal. These blocks were cut into sections in the transverse direction. All the blocks were numbered as in fig. 1 for identification and each block was cut as described above into a complete series of serial sections. (I) THE EXACT DISTRIBUTION OF THE GASTRIC GLANDS IN THE GUINEA-PIG A guinea-pig weighing about 350 grams, after twenty hours starvation, was killed by a blow on the neck. Its stomach was examined exactly as above described. Microscopic Appearances There was no difference between the distribution of the gastric glands on the anterior and- posterior walls, so that they were found to be perfectly symmetrical on the two sides. The length of the lesser curvature of the stretched stomach used in this experiment was 3*5 cm. and the entire distribution length of the pyloric glands on the lesser curvature,-in which no fundus glands were seen,-was about 1-7 cm. from the pyloro-duodenal border. The ratio of the entire distribution length of the pyloric glands to the total length of the lesser curvature was therefore as 17/35 (approximately 5/10 (+)). The length of this distribution on the greater curvature was practically the same as that on the lesser curvature. Intermediate Zone The intermediate zone between the pyloric and the fundus glands was nearly 1 mm. in width and took the form of a slight curved line. There was formed in this way a triangle on both the anterior and the posterior walls, corresponding to the area of the pyloric glands. There was a sudden decrease in the number of the fundus glands and a sudden increase in that of the pyloric glands in the intermediate zone. The gland cells of both kinds were never found intermingled in the same gland tubule, each tubule remaining either entirely of the pyloric or of the fundus type. OXYNTIC CELLS In the pyloric gland area These were never found in group form, but always occurred irregularly in the body of a pyloric gland, taking a parietal position between the ordinary gland cells, exactly as in the case of the cardiac glands. Contrary to the usual teaching, isolated oxvntic cells were found scattered throughout the whole pyloric gland area. 58 Y. Miyagawa In the fundus gland area Oxyntic cells were found of course in the fundus glands in group form as usual, but mostly abounded in the corpus gastricum and prepyloric part, being smaller in number at the funds extreme. In the cardiac gland area The cardiac glands were found in a narrow area in two or three groups immediately surrounding the cardiac orifice and the ordinary gland cells of this part always included a few oxyntic cells. Posterior Atro Wall 8 riwalr 24 23 18 17 6 Posterior wall Anterior wall tCardia 10 25 22 9 16 4 13 26~~~ 21 205is Pyle frus~ ~ ~ ~ udu9lorylandfnlnd Cnre Trnsitionary7line Transitionary Pyl orU5srln Fig. 1. The stretched stomach of a guinea- Fig. 2. The stomach of a guinea-pig (opened pig (divided into areas). in luke-warm saline solution). Macroscopic appearances The macroscopic appearances of the two parts occupied by the pyloric and fundus glands showed the following characteristics. The area occupied by the former glands was much pinker, the mucous membrane being thicker and tougher and more intimately adherent to and more firmly connected with the underlying tissue than that of the fundus gland area. The lines of the rugae in the mucous membrane are longitudinal and particularlymarked along the lesser and greater curvatures in the fundus and the gastric body; but, in the area of the pyloric glands, they are much more oblique or even circular near the pyloric sphincter. The mucous membrane in the area of the funds glands is thinner and softer, being of dark brown pink colour, especially in the centre of the body, and its separation from the underlying tissue is quite easy, large lamellae being formed. Distribution of Gastric Glands in Man and Certain Animals 59 The mathematical determination of the distribution area of the pmjloric glands The distribution area of the pyloric glands can be mathematically determined by drawing a circle, having its centre at the pyloric end of the lesser curvature and having a radius equal to the distance from this centre to the mid-point of the lesser curvature. This circle represents the distribution area of the pyloric glands. (II) THE EXACT DISTRIBUTION OF THE GASTRIC GLANDS IN A NORMAL RABBIT A large rabbit after 24 hours starvation was killed by a blow on the neck and its stomach opened in luke-warm physiological salt solution. The stomach was stretched and pinned out on cork. After fixation it was cut into serial sections and stained, the same methods being employed as in the case of the guinea-pig. Microscopic appearances There was no difference between the distribution of the gastric glands on the anterior and posterior walls,-thus, as in the case of the guinea-pig, they were found to be perfectly symmetrical on the two sides. The lesser curvature in the stretched stomach of this rabbit was 6'5 cm. long and the entire distribution length of the pyloric glands on the lesser curvature-in which no fundus glands were seen,-was about 4-5 cm. from the pyloro- duodenal border. The ratio of the entire distribution length of the pyloric glands to the total length of the lesser curvature may be calculated therefore as 45/65 (approximately 7/10 (+)). The length of this distribution on the greater curvature was practically the same as that on the lesser curvature. The intermediate zone between the pyloric and fundus glands area was nearly 1 mm. in width, taking the form of a line as in the guinea-pig. The distribution area of the pyloric glands is therefore proportionately greater than that of the other animals examined and also of man. Oxyntic cells. A few isolated oxyntic cells were as in the guinea-pig found in the pyloric glands, never in group form as in the case of the human being, but always in the body of the glands, taking a parietal position between the ordinary gland cells. The same statement applies to the cardiac glands. Oxyntic cells were found as usual in group form in the fundus glands being most abundant in the corpus gastricum and the prepyloric part of the stomach. The cardiac glands. The condition of the cardiac glands was found to be practically the same as that of the guinea-pig. The macroscopical characteristic appearances of the distribution area of the pyloric glands The distribution area of these glands as seen after washing the stomach in salt solution immediately after killing the animal was more whitish-pink 60 Y. Miyagawa in colour than that of the fundus glands area, which was much darker and brownish-pink in colour. The course of the folds in the mucous membrane was similar to that in the stomach of the guinea-pig.
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